Supraclavicular Artery Flap versus Skin Graft: Which Is a Better Reconstructive Tool for Managing Post-Burn Contractures in the Neck

Objective: To determine the frequency of success of acellular dermal matrix and split thickness skin graft in release of post burn contractures in hand using Vancouver scar scale. Study Design: Descriptive Case Series. Setting: Department of Plastic Surgery, Jinnah Burn and Reconstructive Surgery Center, Lahore. Period: 1st March, 2019 to 30th October, 2019. Material & Method: A descriptive case series conducted at Plastic Surgery Department, Jinnah Burn and Reconstructive Surgery Center, Lahore. A sample size of 75 patients, who full filled the inclusion criteria, was selected through non probability consecutive sampling Informed consent was obtained from all the patients. Pre-operative photography was done to compare the post-operative results. After the release of contractures, coverage with acellular dermis and split thickness skin graft was performed. All the patients were followed up to 2 months and the outcome was assessed by Vancouver Scar Scale. The collected data was entered and analyzed by using SPSS version 20. Descriptive statistics were calculated. Quantitative variables like age, size of scar were presented as mean, ± standard deviation. Qualitative variables were presented as frequencies and percentages. Results: Mean age of patient was 30 ± 9 years. Among them 40 were males and 35 females. Vancouver scale showed successful outcome (score ≤4) in 70.66 % of the patients. Partial release of contracture was the major complication seen in 5.33% of cases. Conclusion: Acelluar dermal matrix followed by split thickness skin graft is a very reliable option for coverage after release of post-burn contractures in hand as it provides very pliable, thin and lax skin with good color match and better contour to surrounding tissue.

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Matriderm and Split-Thickness Skin Graft for Burn Contractures of the Hands

Juniper Online Journal of Orthopedic and Orthoplastic Surgery ◽

10.19080/jojoos.2020.02.555596 ◽

2020 ◽

Vol 2 (5) ◽

Author(s):

Cezar Buzea

Keyword(s):

Skin Graft ◽

Split Thickness Skin Graft ◽

Thickness Skin ◽

Burn Contractures

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Improving Outcomes in Anterolateral Thigh Flap Donor-Site Reconstruction Using Propeller Flaps: A Retrospective Comparative Study with Skin Grafting

Journal of Reconstructive Microsurgery ◽

10.1055/s-0040-1718550 ◽

2020 ◽

Author(s):

Domenico Pagliara ◽

Maria Lucia Mangialardi ◽

Stefano Vitagliano ◽

Valentina Pino ◽

Marzia Salgarello

Keyword(s):

Comparative Study ◽

Skin Graft ◽

Donor Site ◽

Split Thickness Skin Graft ◽

Tactile Sensitivity ◽

Aesthetic Outcome ◽

Propeller Flap ◽

Thickness Skin ◽

Anterolateral Thigh ◽

Alt Flap

Abstract Background After anterolateral thigh (ALT) flap harvesting, skin graft of the donor site is commonly performed. When the defect width exceeds 8 cm or 16% of thigh circumference, it can determine lower limb function impairment and poor aesthetic outcomes. In our comparative study, we assessed the functional and aesthetic outcomes related to ALT donor-site closure with split-thickness skin graft compared with thigh propeller flap. Methods We enrolled 60 patients with ALT flap donor sites. We considered two groups of ALT donor-site reconstructions: graft group (30 patients) with split-thickness skin graft and flap group (30 patients) with local perforator-based propeller flap. We assessed for each patient the range of motion (ROM) at the hip and knee, tension, numbness, paresthesia, tactile sensitivity, and gait. Regarding the impact on daily life activities, patients completed the lower extremity functional scale (LEFS) questionnaire. Patient satisfaction for aesthetic outcome was obtained with a 5-point Likert scale (from very poor to excellent). Results In the propeller flap group, the ROMs of hip and knee and the LEFS score were significantly higher. At 12-month follow-up, in the graft group, 23 patients reported tension, 19 numbness, 16 paresthesia, 22 reduction of tactile sensitivity, and 5 alteration of gait versus only 5 patients experienced paresthesia and 7 reduction of tactile sensitivity in the propeller flap group. The satisfaction for aesthetic outcome was significantly higher in the propeller flap group. Conclusion In high-tension ALT donor-site closure, the propeller perforator flap should always be considered to avoid split-thickness skin graft with related functional and aesthetic poor results.

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KARSINOMA SEL BASAL NODULOULSERATIF YANG DITERAPI DENGAN EKSISI, FLAP ROTASI DAN SKIN GRAFT

Media Dermato Venereologica Indonesiana ◽

10.33820/mdvi.v46i4.82 ◽

2019 ◽

Vol 46 (4) ◽

Author(s):

Hayra Diah Avianggi ◽

Intan Nurmawati Putri ◽

Muslimin ◽

Retno Indar Widayati

Keyword(s):

Skin Graft

Karsinoma sel basal (KSB) tercatat sebanyak 75% dari semua kanker kulit. Data epidemiologis dunia menunjukkan peningkatan insidensi KSB 3-10% dalam setahun, hal ini diduga berkaitan dengan penipisan lapisan ozon (2% dalam 20 tahun terakhir) dan perubahan gaya hidup. Karsinoma sel basal (KSB) dapat menyebabkan cacat kosmetik maupun cacat fungsional sehingga diperlukan diagnosis dini dan penatalaksanaan yang tepat. Seorang perempuan 72 tahun, dengan keluhan benjolan yang semakin membesar kemudian menjadi borok di pelipis kiri sejak satu tahun. Riwayat sering terpajan sinar matahari. Pada pemeriksaan fisik ditemukan ulkus dengan diameter 3 cm dan krusta. Temuan histopatologik menunjukkan sel ganas dengan inti hiperkromatik dan tepi palisade. Penatalaksanaan dengan bedah eksisi, flap rotasi dan skin graft. KSB jarang bermetastasis, namun dapat mendestruksi jaringan di dekatnya. Studi epidemiologi memberikan fakta bahwa patogenesis KSB dapat terjadi melalui efek imunologik dan karsinogenik. Gambaran histopatologik penting untuk menentukan varian KSB. Prognosis quo ad vitam bonam, ad sanam dubia ad bonam, ad kosmetikam dubia ad bonam.Kata kunci: Bedah eksisi, flap rotasi, karsinoma sel basal, skin graft

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